TY - JOUR
T1 - Mediating effects of exercise capacity on the association between physical activity and health-related quality of life among adolescents with complex congenital heart disease
AU - Kim, Hyun Jeong
AU - Jae, Sae Young
AU - Choo, Jina
AU - Yoon, Ja Kyoung
AU - Kim, Seong Ho
AU - Königstein, Karsten
AU - Schmidt-Trucksäss, Arno
AU - Franklin, Barry A.
N1 - Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objectives: There is little evidence on interrelationships between physical activity, sedentary behaviors, and health-related quality of life (HRQOL) among adolescents with congenital heart disease (CHD). We hypothesized that exercise capacity would have a mediating effect on the associations of either physical activity or sedentary behavior with HRQOL. Methods: Adolescents with complex CHD (n = 111) were consecutively recruited from an outpatient clinic in a general hospital in South Korea. Physical activity and sedentary behavior were assessed using the global physical activity questionnaire. Exercise capacity was directly measured by peak oxygen uptake using a symptom-limited maximal treadmill exercise test. HRQOL was evaluated by both adolescents and their parents using the Pediatric Quality of Life Inventory questionnaire. Results: The self-reported and parent proxy-reported HRQOL were positively associated with physical activity (ß = 0.16, P =.003; ß = 0.12, P =.049) and exercise capacity (ß = 0.63, P <.001; ß = 0.66, P <.001), but not with sedentary behavior in adjusted regression models. When both variables were entered in the same regression models, only exercise capacity remained significantly associated with the self-reported (ß = 0.50, P =.008) and parent proxy-reported HRQOL (ß = 0.62, P =.003). Exercise capacity acted as a full mediator variable on the relationship between physical activity and HRQOL (P <.05 for both). Conclusions: The present findings suggest that exercise capacity mediates the association between physical activity and HRQOL, highlighting the importance of improving exercise capacity to potentially enhance HRQOL in adolescents with complex CHD.
AB - Objectives: There is little evidence on interrelationships between physical activity, sedentary behaviors, and health-related quality of life (HRQOL) among adolescents with congenital heart disease (CHD). We hypothesized that exercise capacity would have a mediating effect on the associations of either physical activity or sedentary behavior with HRQOL. Methods: Adolescents with complex CHD (n = 111) were consecutively recruited from an outpatient clinic in a general hospital in South Korea. Physical activity and sedentary behavior were assessed using the global physical activity questionnaire. Exercise capacity was directly measured by peak oxygen uptake using a symptom-limited maximal treadmill exercise test. HRQOL was evaluated by both adolescents and their parents using the Pediatric Quality of Life Inventory questionnaire. Results: The self-reported and parent proxy-reported HRQOL were positively associated with physical activity (ß = 0.16, P =.003; ß = 0.12, P =.049) and exercise capacity (ß = 0.63, P <.001; ß = 0.66, P <.001), but not with sedentary behavior in adjusted regression models. When both variables were entered in the same regression models, only exercise capacity remained significantly associated with the self-reported (ß = 0.50, P =.008) and parent proxy-reported HRQOL (ß = 0.62, P =.003). Exercise capacity acted as a full mediator variable on the relationship between physical activity and HRQOL (P <.05 for both). Conclusions: The present findings suggest that exercise capacity mediates the association between physical activity and HRQOL, highlighting the importance of improving exercise capacity to potentially enhance HRQOL in adolescents with complex CHD.
UR - http://www.scopus.com/inward/record.url?scp=85069693183&partnerID=8YFLogxK
U2 - 10.1002/ajhb.23297
DO - 10.1002/ajhb.23297
M3 - Article
C2 - 31321831
AN - SCOPUS:85069693183
SN - 1042-0533
VL - 31
JO - American Journal of Human Biology
JF - American Journal of Human Biology
IS - 6
M1 - e23297
ER -